Computer-Assisted Cognitive TX Measures Up
Mahoney, Diana, Clinical Psychiatry News
BOSTON -- Computer-assisted cognitive therapy was shown to be as effective in treating major depression as standard cognitive therapy and required significantly less time spent with a therapist, Dr. Jesse H. Wright reported in a poster presentation at the annual meeting of the Association for Advancement of Behavior Therapy.
In a randomized, controlled study of 45 drug-free subjects with major depression, the overall response rate for 15 patients who were randomly assigned to utilize a multimedia program for computer-assisted cognitive therapy was 69.2%--the same rate as that seen in the 15 patients assigned to receive standard cognitive therapy. The 15 "waiting list" control subjects had an overall response rate of 7.1%. Response was measured with the Beck Depression Inventory (BDI) and the Hamilton Rating Scale for Depression (HRSD).
"The treatment gains [associated with the computer-based therapy] persisted over the 6-month follow-up period," said Dr. Wright, the study's lead investigator.
The software used for the computer-assisted therapy was Cognitive Therapy: A Multimedia Learning Program (Mind-Street), developed by Dr. Wright of the University of Louisville (Ky.) and Dr. Andrew S. Wright of the University of Wisconsin, Madison. The program comprises six modules that cover the core elements of Beck's cognitive therapy for depression. Through text, video, and interactive exercises, users learn to apply standard methods of cognitive therapy, including identifying and modifying automatic thoughts, pleasant-events scheduling, graded-task assignments, working with underlying schemas, and relapse prevention. Feedback via video, audio, and text messages helps guide users through the program. The software generates self-ratings of depression and anxiety based on users' responses to a multiple-choice questionnaire at each computer session and constructs clinician progress reports from the data.
In a preliminary, uncontrolled study, 75 of 96 patients who used the software along with standard treatment completed the program, and most reported high levels of satisfaction in working with it. …